Practical exercises

We have the 4th chapter of our manual dedicated to good practices, tools and exercises for helpers and caregivers of sexually abused children. We present here to you a sample of those exercises aimed to help children cope with a variety of trauma reactions.

16.12 2021

1. Drawing exercise to describe feelings and spaces

Make a drawing of the places a child visits every week. This can open a conversation about the different feelings the child associates with each area. Start with drawing a circle for each place: let the child name them: home, school, out with friends, grandma’s house.

Then ask the child about which feelings they associate with the places. Consider: being joyful, sad, frightened, angry, happy, silly, playful… Ask the child if you should add other feelings. Ask the child to give a colour to each feeling. What is the colour of joy? Of sadness? Let the child choose.

Then ask the child to colour each of the places it visits during the week. Say: “Look at the different places you visit. Which colours should we put in which circle? Think of something that makes you happy / angry / frightened / sad… You can use several colours in each circle.” When all the areas have been coloured, ask the child: “Can you tell me what especially makes you have that feeling in, for example, school? When you are at home? When you are out with grandma’s friends?”

Remember. This exercise creates an opportunity for the child to tell, but that is not the only purpose. If you work together on different colours and different areas, the child may start to feel that you are interested in its whole life, and are not merely an abuse detective. This game can be a good starting point for talking about strategies to seek safety, obtain help and resources, and grow awareness of how to distinguish their feelings.

2. Regain self-agency

At the core of trauma is an intense feeling of helplessness. Abused children may feel they are objects, not subjects in the world and that they wait passively for things to happen to them. Help the child regain feelings of influence and self-agency. In daily life, it is important to distinguish spaces in which the child can take charge, spaces in which it can make plans and have influence, and spaces over which it has no control.

Start by marking a vertical line on a sheet of paper. Discuss with the child something it might want to happen and decide whether it inside or outside its control. Make a list.

When the child has listed what is in its control, make a plan together for doing or achieving one or more of those things.

As a helper you can sometimes assist the child to differentiate between what is possible and what is not. A child may have wishes that are unrealistic – or may give up all its wishes because it believes they are impossible, and therefore not worth trying for.
Restoring hope and facilitating self-agency are of the utmost importance.

Note. “Remembering goodness is as important to healing as remembering hurt” (Lieberman et al).

3. My Engine

This exercise is a simplified version of thewindow of tolerancemetaphor, which can be used with small children.

The helper says to the child:
Imagine you have an engine inside you that drives you along like a car. To stay on the road, cars must adjust their speed. If the road is winding, they must slow down. Also, on steep hills! Our engines do something similar. When they are running slowly we feel tired and it can be difficult to focus on tasks. At other times, we have a lot of energy, we race around and it can be difficult to sit still. When we are learning things, the engine needs to run at the right speed – not too slow and not too fast. Then we can hear what others are saying and take in information we are given.

We also have an alarm system that activates automatically when something threatens us. It allows us to respond quickly and appropriately to sudden changes in our situation. If we are afraid or feel threatened, our energy immediately surges, making us ready to flee or fight. If we cannot resist or escape, however, our bodies tend to shut down. They slow right down, just as an animal plays dead if it cannot escape a predator. This can be an effective defence. We don’t feel as much pain, and immobility may help us to hide. In a way we also hide in our minds. We try not to experience what is happening. Sometimes we escape into fantasy: we let ourselves feel that we can decide what has happened or is going to happen. All of these are ways to protect ourselves.

So, when a child is sexually abused, the engine may go very fast if the child tries to escape, but may slow down to the point where the body does not respond at all. Many children who have been assaulted feel that they did not do enough to stop their abuse, and that this means they even wanted it to happen. In fact, their alarm system was trying to protect them. They responded in a normal way to danger. There is nothing wrong with them.

Sometimes our alarm systems go off when there is no danger. False alarms happen for many reasons. We imagine things in the dark, or misunderstand someone’s behaviour. We even like to awaken our alarm system a little bit by listening to exciting stories or watching frightening films. Some children who have been sexually abused cannot turn their alarm system off, however. They feel they can never relax, must always be vigilant, prepared for bad things to happen. They often feel restless, angry, unable to concentrate, out of control; or they feel exhausted, even numb.

When the alarm system has been used a lot, it is easily activated. A small incident, even a thought, can set it off. This is frightening and very stressful. You are tired when you need energy, and restless when trying to sleep.

Once again, however, there is nothing wrong with children in this situation. Their alarm system is reacting predictably to repeated risk. They need to practice gradually adjusting their engine speed until they can feel comfortable again in ordinary situations.

4. My body

Sexually abused children often have poor body awareness and cannot differentiate their feelings (affect differentiation). Drawing the body and asking a child to locate their feelings on the body can be one way to increase the child’s awareness and connectedness. This exercise can be used as a tool to talk about and differentiate feelings, or to educate about appropriate body boundaries.

Instructions
Make an outline of a human body. (Children below 5 years of age often enjoy it if you draw round their body as they lie on a large sheet of paper.)

Say: “When we have strong feelings, we can usually feel them in our body. For instance, I feel as if my throat is being narrowed when I get scared. I feel a pain in my tummy when I am sad.

Remember the colours you associated with different places you visit every week? Let’s colour your body in the same way. Where do you feel happiness? Where do you feel sadness? Anger? Etc.”

Or: “Where do like to be touched? Where do not like to be touched? Who is allowed to touch which parts of your body? Imagine now that the body is the body of someone else. Which parts of it are OK for you to touch, and which parts should you not touch?

5. The three houses

Children seek mastery and normality and are longing for good things. Traumatic events and abuse may overshadow good things in their lives and block their capacity to hope and dream about the future. At the same time, their worries need to be out in the open.

In this exercise, the child lists what the “houses” below should contain.

Discuss all the houses thoroughly.

6. Using a box with a lid

The helper can use this exercise to end a session and make the child feel safer about what has been said. Always end with some words of praise.

The helper: “I know that this was hard for you. You have been very brave. Well done!” “Before we finish, let us make a drawing (or a little story) about what happened to you, the things we have talked about that scared you (use the word the child has used for the abuse) and put it in this box and close it with a lid. Then I can keep it in a safe place here.”

“We can open it when we want to. But in the meantime, it will stay locked up. Until you feel like talking again. We will know that it is safe here.”